{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T18:10:06Z","timestamp":1756318206959,"version":"3.44.0"},"reference-count":11,"publisher":"BMJ","issue":"1","funder":[{"DOI":"10.13039\/501100002926","name":"Cambridge University Hospitals","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100002926","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Deanery"},{"DOI":"10.13039\/501100000272","name":"National Institute for Health Research","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2024,11,22]]},"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:p>We present a case of a male in his early 50s assessed in the emergency department with a seemingly clear alcohol history but with classic symptoms of Wernicke\u2019s encephalopathy (WE): disorientation, gait ataxia and vertical nystagmus. He also had significant bilateral hearing loss and profound anterograde amnesia. Neuroimaging revealed hallmark signs of WE, including symmetrical T2\/fluid-attenuated inversion recovery hyperintensity in the medial thalami. Here, we consider important differentials beyond WE, discuss the importance of revisiting the patient\u2019s history and explore the significance of his imaging findings. Although the patient\u2019s cognitive function and ocular symptoms improved on standard treatment, his condition progressed to Korsakoff\u2019s syndrome accompanied by residual anterograde amnesia and ongoing confabulation that required cognitive rehabilitation.<\/jats:p>","DOI":"10.1136\/bcr-2024-263527","type":"journal-article","created":{"date-parts":[[2025,1,19]],"date-time":"2025-01-19T20:50:45Z","timestamp":1737319845000},"page":"e263527","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Wernicke\u2019s encephalopathy presenting with confusion and hearing loss"],"prefix":"10.1136","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2770-3075","authenticated-orcid":false,"given":"Lucy","family":"Carson","sequence":"first","affiliation":[{"name":"Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Munashe","family":"Veremu","sequence":"additional","affiliation":[{"name":"Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aaron","family":"Jesuthasan","sequence":"additional","affiliation":[{"name":"Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Timothy","family":"Ham","sequence":"additional","affiliation":[{"name":"Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,1,19]]},"reference":[{"key":"2025082710402698000_18.1.e263527.1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(07)70104-7"},{"key":"2025082710402698000_18.1.e263527.2","doi-asserted-by":"publisher","DOI":"10.1177\/1533210110392941"},{"key":"2025082710402698000_18.1.e263527.3","doi-asserted-by":"crossref","unstructured":"Nardone R , H\u00f6ller Y , Storti M , et al . Thiamine Deficiency Induced Neurochemical, Neuroanatomical, and Neuropsychological Alterations: A Reappraisal. ScientificWorldJournal 2013;2013. doi:10.1155\/2013\/309143","DOI":"10.1155\/2013\/309143"},{"key":"2025082710402698000_18.1.e263527.4","doi-asserted-by":"crossref","first-page":"401","DOI":"10.1016\/j.jemermed.2016.05.044","article-title":"Psychiatric Emergencies for Clinicians: Emergency Department Management of Wernicke-Korsakoff Syndrome","volume":"51","author":"Sharp","year":"2016","journal-title":"J Emerg Med"},{"key":"2025082710402698000_18.1.e263527.5","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A0544"},{"key":"2025082710402698000_18.1.e263527.6","first-page":"117","article-title":"The Wernicke-Korsakoff syndrome and related neurologic disorders due to alcoholism and malnutrition","volume":"92","author":"Bruyn","year":"1989","journal-title":"J Neurol Sci"},{"key":"2025082710402698000_18.1.e263527.7","doi-asserted-by":"crossref","first-page":"E15","DOI":"10.1176\/appi.neuropsych.11090230","article-title":"Wernicke\u2019s encephalopathy mimicking an acute psychotic disorder","volume":"24","author":"Chen","year":"2012","journal-title":"J Neuropsychiatry Clin Neurosci"},{"key":"2025082710402698000_18.1.e263527.8","doi-asserted-by":"publisher","DOI":"10.1016\/j.psym.2018.03.011"},{"key":"2025082710402698000_18.1.e263527.9","unstructured":"Day G . Wernicke\u2019s encephalopathy - symptoms, diagnosis and treatment | bmj best practice. Available: https:\/\/bestpractice.bmj.com\/topics\/en-gb\/405 [Accessed 4 Nov 2024]."},{"key":"2025082710402698000_18.1.e263527.10","doi-asserted-by":"publisher","DOI":"10.1093\/alcalc\/agn103"},{"key":"2025082710402698000_18.1.e263527.11","doi-asserted-by":"crossref","first-page":"917","DOI":"10.1111\/jon.13143","article-title":"The role of MRI in the prognosis of Wernicke\u2019s encephalopathy","volume":"33","author":"Kitaguchi","year":"2023","journal-title":"J Neuroimaging"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2024-263527","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T17:40:33Z","timestamp":1756316433000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2024-263527"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1]]},"references-count":11,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,1,19]]},"published-print":{"date-parts":[[2025,1]]}},"alternative-id":["10.1136\/bcr-2024-263527"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2024-263527","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2025,1]]}}}